Nursing Elites

1. A client with type 2 diabetes mellitus is receiving metformin (Glucophage). Which laboratory test should the LPN/LVN monitor while the client is taking this medication?

• A. Complete blood count (CBC)
• B. Liver function tests
• C. Serum electrolytes
• D. Renal function tests

Correct answer: B

Rationale: The correct answer is B: Liver function tests. While a client is taking metformin, monitoring liver function tests is crucial to assess for potential hepatic side effects. Metformin is primarily eliminated by the liver, and monitoring liver function tests helps in early detection of any liver-related complications. Choices A, C, and D are incorrect. A complete blood count (CBC) is not specifically required for monitoring metformin therapy. Serum electrolytes are not directly impacted by metformin, making it less relevant for monitoring this medication. Renal function tests are important for some other diabetes medications, but in the case of metformin, liver function tests take precedence due to its hepatic metabolism.

2. While ambulating an unsteady client who begins to fall, which of the following actions should the nurse take?

• A. Allow the client to slide down their outstretched leg.
• B. Place their arms around the client to prevent the fall.
• C. Remain upright as the client falls toward them.
• D. Move quickly to a position in front of the client.

Correct answer: A

Rationale: When a client is falling, allowing them to slide down your leg can help control the descent and prevent injury. This technique ensures a more controlled fall compared to attempting to catch or stop the client abruptly, which could lead to both the client and the nurse getting injured. Placing arms around the client may not provide enough support or control during the fall. Remaining upright or moving quickly in front of the client might not be practical or safe in this scenario.

3. A client on a telemetry unit is being cared for by a nurse after a myocardial infarction. The client expresses, 'All this equipment is making me nervous.' Which of the following responses should the nurse make?

• A. 'All of this equipment can be frightening.'
• B. 'The equipment is necessary to monitor your condition.'
• C. 'You should try to ignore the equipment.'
• D. 'Try to relax; the equipment is not harmful.'

Correct answer: A

Rationale: Choice A is the most appropriate response as it acknowledges the client's feelings, showing empathy and understanding. It validates the client's experience, which can help reduce anxiety and build rapport. Choice B provides information but may not address the client's emotional needs. Choice C dismisses the client's concerns and does not offer support. Choice D minimizes the client's feelings and may not effectively address their anxiety.

4. A client is 6 hours postoperative following abdominal surgery and is having difficulty voiding. Which of the following actions should the nurse take?

• A. Allow the client to hear running water while attempting to void
• B. Provide the client with a bedpan while sitting upright
• C. Insert an indwelling urinary catheter and connect it to gravity drainage
• D. Encourage the client to limit fluid intake

Correct answer: A

Rationale: The correct action for the nurse to take in this situation is to allow the client to hear running water while attempting to void. This can help stimulate the urge to urinate in a non-invasive way, promoting natural voiding. Providing a bedpan while sitting upright is also a suitable approach to facilitate voiding by encouraging a more natural position. Inserting an indwelling urinary catheter should be a last resort due to infection risks and discomfort associated with catheterization. Encouraging the client to limit fluid intake is not appropriate as hydration is crucial for overall health and can aid in promoting voiding. Therefore, the best initial intervention to promote voiding in this scenario is to allow the client to hear running water.

5. A healthcare professional is explaining the use of written consent forms to a newly-licensed healthcare professional. The healthcare professional should ensure that a written consent form has been signed by which of the following clients?

• A. A client who has a prescription for a transfusion of packed red blood cells.
• B. A client who is scheduled for a routine physical examination.
• C. A client who is undergoing a minor surgical procedure without anesthesia.
• D. A client who has been prescribed a new medication.

Correct answer: A

Rationale: Correct! Written consent is required for procedures that carry significant risks, such as blood transfusions, to ensure the client’s informed consent and understanding of the procedure. In this case, a transfusion of packed red blood cells is an invasive procedure that carries risks, making it essential to have the client's written consent. Choices B, C, and D do not typically require written consent as routine physical examinations, minor surgical procedures without anesthesia, and new medication prescriptions do not carry the same level of risk and complexity as a blood transfusion.

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